Ethnic Differences in Utilization of an Outpatient Clinic in the Netherlands: a study of diabetes patients and patients with gastrointestinal symptoms

This thesis contains studies about ethnic differences in processes and outcomes of
outpatient hospital care, with special attention to diabetes mellitus and gastrointesti
nal complaints. Currently, about 10% of the population that lives in the Netherlands
is of non-western origin. These are persons of which at least one parent is born in
a non-western country. As a result of the increasing numbers of immigrant groups,
the Netherlands is facing numerous new challenges. One issue of special interest is
the consequence for population health. Current knowledge about ethnic differences
demonstrates a worse self-reported health among ethnic minorities compared to native
Dutch people, and differences in general morbidity and mortality. Explanatory
factors are for example genetic factors, cultural behavior, effects of migration, effects
of racism, exposure to health promoting and health damaging factors in the country
of origin and in the Netherlands. Furthermore, differences are attributed to environmental
and economic factors. However, these factors do not fully explain the ethnic
differences. Health care itself could be of importance in explaining the ethnic differences,
mainly the access and the quality of care. International and national literature
did not provide sufficient information about ethnic differences in relation to health
care processes in the Netherlands. This is the reason why we formulated a research
project to analyze ethnic differences in health care processes. To be specific, in this
thesis we compared health care processes and outcomes of outpatient hospital care
among immigrant patients and native Dutch patients, with special attention for diabetes
mellitus and gastrointestinal complaints. Immigrant patients were restricted to
non-western immigrants from Turkish, Moroccan, Surinamese, Cape Verdean and
Antillean and Aruban descent.

Lanting, L.C. (2007, February 9). Ethnic Differences in Utilization of an Outpatient Clinic in the Netherlands: a study of diabetes patients and patients with gastrointestinal symptoms. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/8577